Healthcare Provider Details

I. General information

NPI: 1598177909
Provider Name (Legal Business Name): E & C HOUSING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 05/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 HAYNES PARK DR
NASHVILLE TN
37218-1928
US

IV. Provider business mailing address

208 HAYNES PARK DR
NASHVILLE TN
37218-1928
US

V. Phone/Fax

Practice location:
  • Phone: 615-593-6581
  • Fax: 615-822-1869
Mailing address:
  • Phone: 615-593-6581
  • Fax: 615-822-1869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License NumberI000000013771
License Number StateTN

VIII. Authorized Official

Name: CANDACE LEE GRAY
Title or Position: RESPIRATORY THERAPIST
Credential: CRT
Phone: 615-593-6581